Question:

My test results have been inconclusive.  Is there something more definitive which could be done?

I am a 48 y/o female. Previously active and in very good health — after sudden symptoms of extreme, unusual fatigue, dizziness, and chest pain with minimal exertion, I underwent a series of cardiac tests. Angiogram revealed “RCA arising from the left cusp following a preaortic course into the right AV groove”. Testing has been inconclusive – disabling symptoms have persisted for 3 months. Symptoms relieved by nitroglycerin, taking 30mg nifedipine with limited relief. Due to the rare nature of this, is it possible that clear, conclusive testing results could be elusive?

Submitted by Donna from Canada on 01/02/2014

Answer:
by Roberto Lufschanowski, MD

Dear Donna: Your condition is not so rare, but is difficult to define precisely. What we do which helps clarify the diagnosis and therapy is intravascular imaging (called Ivus). This gives a real time picture of the anatomy. What we look for is compression of the lumen of the artery under different conditions. Sounds complicated, but it is a routine technique. Good luck.